Patients ages 18 and above will be randomized either to Azmacort at an initial delivered dose of 200 mcg, taken two puffs four times daily (800 mcg total daily dose) plus inhaled beta-2 agonist as needed or four times daily inhaled placebo plus beta-2 agonist as needed. The subsequent dosing frequency of Azmacort may be adjusted at the treating physicians discretion so as to maintain a total daily dose of 800 mcg (i.e. 400 mcg BID). The study will be divided into two phases: 1) a two week screening and baseline evaluation phase, and 2) a one year double blind period with brief follow-ups at three, six, nine, and 12 months.